I don’t diagnose Chickenpox often. I’ve seen patients with Chickenpox only a handful of times since I started medical school in 1998. Auspiciously, there simply haven’t been many children to serve as my teachers. Varicella virus causes Chickenpox and there’s a vaccine for that. So, like Smallpox or Polio, I’ve been forced to learn a lot about Chickenpox in textbooks. My strongest professor in the Chickenpox department is my own memory; I had Varicella between the age of 5 and 6 years. It was the one week of my childhood where I remember being really babied– my mom gave me a small gift or craft every day while I was home from school. I got to watch TV on the couch. I must have looked pretty awful…But it wasn’t so bad and I was lucky. I was a healthy 5 year old girl who had a case of chicken pox that was “run of the mill”: lots of spots, lots of itching, a week of fever and feeling crummy. Then poof, I scabbed over and got better. The only remaining trace (besides the virus that may live in my nerves) is the scar on my L forehead. You seen it?
The big trouble with Chickenpox is you can’t predict which child will have a serious complication (a brain infection, an overgrowth of flesh eating bacteria in the sores, or a life-threatening pneumonia).
While I was finishing up college, the Varicella vaccination was introduced into the United States. At that time, over 150 people died every year from Chickenpox and over 11,000 people were hospitalized annually. This created a huge economic toll (from missed work to health care costs).
So my apparent lack of clinical opportunity with Chickenpox reflects reality. A study published this week found that over the last 12 years there has been a 97% reduction in deaths from Chickenpox in children and adolescents younger than 20 years of age. There’s been an 88% reduction of Chickenpox deaths over all (kids plus adults). These are staggering statistics.
Varicella and Varicella Vaccine in the US:
- Prior to the mid-1990’s, Varicella caused hundreds of deaths every single year. It caused thousands more hospitalizations.
- Since 1995, we’ve been vaccinating children between 12 and 18 months of age against Varicella (Chickenpox). Some children can’t receive the vaccine (those with suppressed immune systems, history of recent bone marrow transplant, or cancer for example) so they are protected by those vaccinated. I have plenty of patients who are protected by YOU/YOUR children being vaccinated. Thank you.
- Between 1997 and 2007, only 77 total people died from Chickenpox.
- Between 1997 and 2007, the rate of those vaccinated against Chickenpox increased from 27% to 90%!
- In 2002, we started to do a booster dose for Varicella at 4-6 years of age to increase protection against Chickenpox. We have been catching up all other children with another dose and now when children enter kindergarten, very child should have 2 doses total. The reason: research has found that 1 dose of the vaccine is 85% effective in preventing all Varicella but with 2 doses, effectiveness rises to 97-100%.
- Most of the 77 deaths occurred in patients “without apparent contraindication to vaccination” and therefore were potentially preventable. (Major missed opportunity)
- The vaccine works. Of the 77 total deaths since 1997, only 2 deaths occurred in children who had received 1 dose of the Varicella shot. Both of those children were on steroid therapy (suppressing their immune system) and 1 of the children had cancer.
This tells us we’re living in a wonderful era where few die from Chickenpox disease and complications. We’ve created a safer environment. If your a child born in 2011 and get the Varicella vaccine and have no other immune-related medical problems, the likelihood of dying from Chickenpox disease is nearing zero. Further, through the combination of your own immunization and from the protection of the “herd” of vaccinated children around you, you’re even better protected. Well done, everyone. We should be very proud of ourselves. This is a big accomplishment; keep up the good work.
PS–a note on the photo. Chickens don’t cause or spread Chickenpox.